| National Provider Identifier [NPI]: | 1235350299 |
| Last Name Of The Provider | HIGGINSON |
| First Name Of The Provider | SEAN |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1715 DEER TRACKS TRL |
| Street Address 2 Of The Provider | SUITE 130 |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631311839 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 178 |
| Number Of Services | 12724 |
| Number Of Medicare Beneficiaries | 4400 |
| Total Submitted Charge Amount | 931363.06 |
| Total Medicare Allowed Amount | 299793.16 |
| Total Medicare Payment Amount | 227895.11 |
| Total Medicare Standardized Payment Amount | 236171.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 6417 |
| Number Of Medicare Beneficiaries With Drug Services | 84 |
| Total Drug Submitted ChargeAmount | 5581.06 |
| Total Drug Medicare AllowedAmount | 2014.26 |
| Total Drug Medicare PaymentAmount | 1544.49 |
| Total Drug Medicare Standardized Payment Amount | 1544.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 175 |
| Number Of Medical Services | 6307 |
| Number Of Medicare Beneficiaries With Medical Services | 4400 |
| Total Medical Submitted Charge Amount | 925782 |
| Total Medical Medicare Allowed Amount | 297778.9 |
| Total Medical Medicare Payment Amount | 226350.62 |
| Total Medical Medicare Standardized Payment Amount | 234626.79 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 771 |
| Number Of Beneficiaries Age 65 to 74 | 1511 |
| Number Of Beneficiaries Age 75 to 84 | 1322 |
| Number Of Beneficiaries Age Greater 84 | 796 |
| Number Of Female Beneficiaries | 2584 |
| Number Of Male Beneficiaries | 1816 |
| Number Of Non Hispanic White Beneficiaries | 3630 |
| Number Of Black or African American Beneficiaries | 683 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3328 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1072 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.7203 |